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2.10 Hordeolum (Sty)


Presentation

The patient complains of redness, swelling, and pain in the eyelid, perhaps at the base of an eyelash (sty or external hordeolum) or deep within the lid (meibomianitis or internal hordeolum, best appreciated with the lid everted) perhaps with conjunctivitis and purulent drainage.

What to do:

What not to do:

Discussion

The terminology of the two types of hordeolum have become confusing. Meibomian glands run vertically, within the tarsal plate, open at tiny puncta along the lid margin, and secrete oil to coat the tear film. The glands of Zeiss and Moll are the sebaceous glands opening into the follicles of the eyelashes. Both can become occluded and superinfected, producing meibomianitis (internal hordeolum) or a sty (external hordeolum). The ED care of both acute infections is the same. A chronic granuloma of the meibomian gland is called a chalazion, will not drain, and requires excision.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
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